In-Office GYN Procedures

A colposcopy is a procedure done in the office that allows your doctor to evaluate your vagina and cervix with a bright light and a magnifying lens. This procedure allows your doctor to see problems that are not visible to the naked eye.

Your practitioner may recommend a colposcopy for several reasons. Most commonly it is done to get more information about the cervix after an abnormal pap smear. It may also be recommended if there is an abnormal appearance of your cervix, vagina, or vulva at the time of your routine gynecological exam. At times it is suggested to evaluate abnormal bleeding or growths on the cervix.

A colposcopy typically takes 10-15 minutes. It is best done when you don’t have your period. For 24 hours before the test, you should not have anything in the vagina (intercourse, tampons, douching, vaginal medications).

During the exam, a speculum will be placed in your vagina so that your cervix can be seen. A solution will be placed in your vagina and on your cervix that makes the abnormal areas easier to see. There may be some mild discomfort associated with this.

The doctor may perform a biopsy (remove a small piece of tissue) at the time of the colposcopy. There may be some cramping or pain if a biopsy is performed. This discomfort is usually brief.

If you have a colposcopy without a biopsy, your recovery time is minimal, and you can quickly return to routine activities. If you have a colposcopy with a biopsy, you may experience some pain and discomfort for 1 or 2 days following the procedure as well as vaginal bleeding or dark discharge. You may need to wear a sanitary pad until the discharge stops. Your doctor will discuss with you appropriate medication for pain relief.

Also, it is generally recommended that physical activity be reduced for a brief time following a colposcopy with a biopsy. While your cervix heals, you should refrain from having sexual intercourse, using tampons and douching.

Hysteroscopy is a minimally invasive procedure that provides a way to look inside the uterus. This procedure utilizes a hysteroscope, which is a thin, lighted telescope that is inserted through the vagina and cervix and into the uterus. The hysteroscope transmits the image of your uterus onto a screen for your doctor to review.

Diagnostic hysteroscopy can usually be done in the clinic setting without anesthesia. The procedure allows the surgeon to diagnose certain conditions such as abnormal uterine bleeding (if a woman’s menstrual periods are heavier or longer than usual), infertility or the cause of repeated miscarriages, adhesions, polyps, or fibroids.

An operative hysteroscopy may be used to both diagnose and treat certain conditions such as abnormal uterine bleeding, infertility, adhesions, septums, polyps, or fibroids, which can often be removed through the hysteroscope. Although these procedures are more complex and are often done in an operating room setting with anesthesia, patients can go home the same day (outpatient surgery).

The hysteroscopy procedure is scheduled when you are not having your menstrual period. You should be able to go home shortly after the procedure. Following the hysteroscopy, it is normal for patients to experience mild cramping or a little bloody discharge for a few days. Your doctor will advise you on the most appropriate medication you should take to help ease any pain you experience.

A LEEP, or Loop Electrosurgical Excision Procedure, is performed to remove abnormal cells from the surface of the cervix. Your practitioner may recommend that you have this procedure if you’ve had an abnormal pap. It is helpful in diagnosing and treating the abnormal cells in the cervix.

The LEEP procedure is typically done in the office at a time when you are not menstruating.

The procedure only takes a few minutes. A speculum will be placed in your vagina to see your cervix. A colposcopy may be performed just before the LEEP to help identify the location of the abnormal tissue. Usually, a local anesthetic or numbing medicine is used to lessen the discomfort of the procedure.

The procedure is done with a small wire loop that has an electrical current that quickly cuts through the cervical tissue to remove the abnormal portion. Once the tissue is removed, it is sent to the laboratory to be sure that all of the abnormal cells were removed and to more accurately evaluate the degree of the abnormality.

After the procedure, you may experience some mild cramping. Taking ibuprofen can help to lessen the discomfort. You will also notice some vaginal discharge for a time while your cervix heals. It is important that you not put anything in your vagina, such as tampons or douches, or have intercourse until your cervix is healed. Your doctor will tell you when it is safe to use tampons or have sex. If you have either heavy bleeding or foul-smelling discharge, you should call the office.

Although most women have no problems, there is a small increase in the risk of premature births and having a low birth weight baby. In rare cases, the cervix is narrowed after the procedure. This narrowing may cause problems with menstruation.

After any in-office surgical procedure, you will need to schedule an appointment for a follow-up visit, as indicated by the procedure or any test results.

Following LEEP, you will have cervical cancer screening to be sure that all of the abnormal cells are gone and that they have not returned.

You can help protect the health of your cervix by following these guidelines:

• Have regular pelvic exams and cervical cancer screening.
• Quit smoking—smoking increases your risk of cervical cancer.
• Limit your number of sexual partners and use condoms to reduce your risk of sexually transmitted infections (STIs).

Learn more about cervical health in this blog post.